Skill Profile
Clinical Medicines Review
"The observable action of systematically evaluating a patient's complete medication regimen in order to identify and resolve prescribing problems, optimise therapeutic outcomes, and reduce medication-related harm."
YOUR SKILLS
Problems This Skill Solves
- Patients on multiple medicines experiencing preventable adverse effects or drug interactions
- Medications prescribed for conditions that have resolved or that no longer reflect clinical evidence
- Hospital admissions caused by medication-related problems in community patients
- Polypharmacy in older adults causing falls, cognitive impairment, or poor quality of life
Tools Used
"Medicines reviews are about stopping as many drugs as possible."
Medicines reviews are about optimisation, not minimisation. Sometimes the outcome is adding a missing medicine (e.g. a cardioprotective agent that was never started), adjusting a dose, or improving adherence. The goal is ensuring every medicine is appropriate, effective, safe, and necessary for that specific patient — which sometimes means more medicines, not fewer.
Research & Outlook
Clinical medicines reviews are becoming a core function of integrated primary care teams, with clinical pharmacists embedded in GP practices and care homes across England as part of NHS long-term plan workforce expansion. AI-supported prescribing safety tools are improving the detection of inappropriate prescribing at scale. The demand for qualified independent prescribers with medicines optimisation expertise is high and growing, particularly in ageing populations with complex polypharmacy.
See This Skill In Action
Watch a professional demonstrate Clinical Medicines Review in a real working environment — what it looks like, how it's applied, and why it matters.
Healthcare / Pharmacy & Prescribing
Clinical Medicines Review
Also Known As
Growth Path
Conducts a basic medicines reconciliation on admission, identifying discrepancies between prescribed and actual medicines. Checks for known interactions and contraindications using BNF. Escalates concerns to the prescribing clinician.
Independently conducts clinical medicines reviews for patients with complex or multiple long-term conditions. Applies STOPP/START criteria and NICE polypharmacy guidance. Recommends stopping, starting, or adjusting medicines with clinical justification. Communicates changes clearly to patient and clinical team.
Leads medicines optimisation programmes at practice, PCN, or Trust level. Designs review frameworks, trains other clinicians, and demonstrates population-level impact (e.g. reduction in high-risk prescribing, unplanned admissions). Holds independent prescribing authority and manages complex patients autonomously.
How to Practise
- 1.Complete a Structured Medication Review for a patient on 10+ medicines, documenting each medicine's indication, dose appropriateness, and any identified issues.
- 2.Apply STOPP/START criteria to a case of polypharmacy in an older patient and identify potentially inappropriate prescribing.
- 3.Attend medicines optimisation clinics or GP pharmacist attachment to observe medication reviews in practice.
- 4.Work through clinical cases involving adverse drug reactions and identify the causative agent and safer alternative.
How to Prove
- ·Independent prescribing qualification (for pharmacists and nurse prescribers)
- ·Evidence of completed Structured Medication Reviews in NHS primary care (GP IT system records)
- ·Audit of medication review outcomes (e.g. number of medicines stopped, admissions prevented)
- ·Postgraduate Diploma in Clinical Pharmacy or equivalent advanced practice qualification